Inquiries about Medicare coverage for PureWick external catheters?
Managing Incontinence Just Got Easier: A New Lease of Life with PureWick
Struggling with incontinence during your sleep? Worry no more! The innovative PureWick system, exclusively designed for females, offers a solution that enhances your rest and peace of mind. This system includes an external catheter that gently extends from the vulva to the buttocks, connecting to a tube leading to a collection container. position it comfortably on a nightstand or table.
The PureWick system made headlines in 2024, when the Centers for Medicare & Medicaid Services (CMS) introduced a ruling enabling it to be covered under the durable medical equipment (DME) benefit of Part B.
So, what's the deal with Medicare and PureWick? Here's the scoop.
Medicare: Your Savior in Healthcare
For those unacquainted, Medicare Part B offers coverage for DME. DME encompasses essential medical items like oxygen supplies, walkers, and hospital beds. To get a qualifying device, all you need is a Medicare-enrolled doctor or healthcare professional to prescribe it for home use.
DME includes external catheters as alternatives to indwelling catheters, and as of 2024, the PureWick system made it to the list. However, it's important to note that Medicare won't approve coverage if you also have an indwelling catheter. Furthermore, for female catheters, Medicare stipulates a limit of using no more than one metal cup or pouch per week. In a hospital setting, catheters are covered by Part A.
Pricing Breakdown: A Money Matter
Wondering how much the PureWick system costs under Medicare? As disclosed on the manufacturer's website, a box of 30 catheters sets you back approximately $209 for those paying out of pocket without insurance. But don't fret, bulk purchases can help save some cents.
As per 2025 updates, those enrolled in Medicare Part B must first meet an annual deductible of $257 before Medicare starts to chip in for covered services or equipment. After meeting the deductible, enrollees pay a monthly premium of $185 for Part B coverage. Once conditions are met, Part B covers 80% of the approved treatments or services, leaving you to foot the remaining 20%.
Deciphering Medicare Jargon
- Out-of-pocket cost: The portion you pay for care when Medicare doesn't cover everything or offer coverage. This can include deductibles, premiums, coinsurance, and copayments.
- Premium: The monthly amount you shell out for Medicare coverage.
- Deductible: The annual amount you must spend out-of-pocket before Medicare begins to fund your treatments.
- Coinsurance: The percentage of treatment costs that you must cover. For Medicare Part B, this is usually 20%.
- Copayment: A fixed payment you pay when you receive specific treatments. Typically, this applies to prescription drugs.
- The PureWick system, designed for women who struggle with incontinence during sleep, is now covered under the durable medical equipment (DME) benefit of Medicare Part B.
- Medicare Part B offers coverage for DME items like oxygen supplies, walkers, and hospital beds, and now includes the PureWick system as a qualifying device.
- To get a qualifying device under Medicare Part B, a Medicare-enrolled doctor or healthcare professional must prescribe it for home use.
- However, Medicare won't approve coverage for the PureWick system if the individual already has an indwelling catheter and also imposes a limit of using no more than one metal cup or pouch per week.
- A box of 30 PureWick catheters costs approximately $209 for those who pay out of pocket without insurance, but bulk purchases can help save some money.
- As of 2025 updates, those enrolled in Medicare Part B must first meet an annual deductible of $257 before Medicare starts to cover 80% of the costs, leaving the individual to pay 20%.
